tbuckley/cabot-search huggingface dataset:
Clinico-endoscopic and biochemical parallels of chronic inflammatory bowel diseases with positive inflammatory markers
Authors: Yu.M. Stepanov, T.S. Tarasova, M.V. Stoykevich, O.V. Simonova, O.M. Tatarchuk
Journal: GASTROENTEROLOGY (2023)

Background. The prevalence of inflammatory bowel disease (IBD) is currently increasing worldwide and represents a serious problem that causes interest in the study and, especially, in the development of less invasive diagnostic measures. In the studies of years on the diagnosis of IBD, there are data indicating the possibility of using IgG4 as a diagnostic biomarker. Purpose: to investigate the peculiarities of endoscopic manifestations and activity of IBD depending on the disease severity, the levels of fecal calprotectin (FC) and IgG4. Materials and methods. One hundred patients with IBD were examined, including 75 people with ulcerative colitis (UC) and 25 with Crohn’s disease (CD). Patients were divided into groups depending on the nosology and severity of the course. All of them underwent an endoscopic examination to verify the diagnosis; the level of IgG, IgG4 in blood serum, the IgG4/IgG ratio, and the content of FC were determined. Results. A significant increase in the degree of endoscopic activity was detected along with an increase in the severity of ulcerative colitis and Crohn’s disease. It was found that the level of FC increased with increasing severity of UC and CD. In patients with UC and CD, a probable decrease in the level of IgG was revealed (p&lt;0.05). The concentration of IgG4 in the group of patients with UC was 2.3 (p&lt;0.05) and 2.5 times (p&lt;0.05) higher compared to the control group and patients with CD, respectively. A correlation was found between the level of IgG4 and the index of Best, the degree of severity, the localization of the inflammatory process in the colon, and the ratio of IgG4/IgG. The relationship of the IgG4/IgG ratio with the endoscopic index of IBD activity and serum IgG4 was revealed. Conclusions. The degree of endoscopic activity of IBD increased along with the severity of the disease. A positive correlation was found between the FC level and the severity of IBD and an inverse correlation— with IgG level. The level of IgG4 depended on the endoscopic activity of IBD, which was confirmed by a correlation. A 2-fold (p&lt;0.05) and 2.5-fold (p&lt;0.05) increase was found in the concentration of IgG4 in the blood serum of patients with UC compared to the control group and patients with CD, respectively. The obtained data can be used for differential diagnosis of UC and CD.
National Policy Development for the Clinical Application of Genetic Diagnostic Technologies
Authors: Benjamin S. Wilfond
Journal: JAMA (1993)

In recognition of the earlier experiences with genetic diagnostic services and in anticipation of a greater potential for genetic testing for presymptomatic disease and disease susceptibility, this article provides an analysis of policy development for cystic fibrosis carrier screening. The deficiencies of relying on an extemporaneous model for health policy development are described. Preferably, an evidentiary model, based on the evaluation of clinical research and incorporating professional and public attention to underlying normative issues, should define the standard of care. Appropriate procedural mechanisms should be established at both state and federal levels to prevent the unnecessary confusion, expense, and personal or social harms likely to result from a completely unrestrained application of developing genetic technologies or continuing ad hoc responses to rapid increases in genetic diagnostic capabilities. A broadly constituted national advisory commission on the ethical, legal, and social implications of the Human Genome Project would provide an important locus for national decision making and may offer an efficient mechanism for implementing the evidentiary model, promoting public involvement at a time when social policy decisions must be made to restructure the health care system to be more sensitive to issues of access, allocation, and costs. (<i>JAMA</i>. 1993;270:2948-2954)
Joint Study of Extracranial Arterial Occlusion
Authors: William K. Hass
Journal: JAMA (1968)

For 80% of 4,748 patients with cerebrovascular insufficiency, complete four-vessel examinations were made. Although the primary purpose was localization of surgically accessible extracranial lesions, intracranial studies were also obtained in a high percentage of cases. The overall grave complication rate was 1.2%. A test of interinstitutional comparability of x-ray interpretation revealed greatest agreement when lesions compromised more than 50% of the arterial lumen.
Effects of Smoking Intervention and the Use of an Inhaled Anticholinergic Bronchodilator on the Rate of Decline of FEV1
Authors: Nicholas R. Anthonisen
Journal: JAMA (1994)

<h3>Objective.</h3> —To determine whether a program incorporating smoking intervention and use of an inhaled bronchodilator can slow the rate of decline in forced expiratory volume in 1 second (FEV<sub>1</sub>) in smokers aged 35 to 60 years who have mild obstructive pulmonary disease. <h3>Design.</h3> —Randomized clinical trial. Participants randomized with equal probability to one of the following groups: (1) smoking intervention plus bronchodilator, (2) smoking intervention plus placebo, or (3) no intervention. <h3>Setting.</h3> —Ten clinical centers in the United States and Canada. <h3>Participants.</h3> —A total of 5887 male and female smokers, aged 35 to 60 years, with spirometric signs of early chronic obstructive pulmonary disease. <h3>Interventions.</h3> —Smoking intervention: intensive 12-session smoking cessation program combining behavior modification and use of nicotine gum, with continuing 5-year maintenance program to minimize relapse. Bronchodilator: ipratropium bromide prescribed three times daily (two puffs per time) from a metered-dose inhaler. <h3>Main Outcome Measures.</h3> —Rate of change and cumulative change in FEV<sub>1</sub>over a 5-year period. <h3>Results.</h3> —Participants in the two smoking intervention groups showed significantly smaller declines in FEV<sub>1</sub>than did those in the control group. Most of this difference occurred during the first year following entry into the study and was attributable to smoking cessation, with those who achieved sustained smoking cessation experiencing the largest benefit. The small noncumulative benefit associated with use of the active bronchodilator vanished after the bronchodilator was discontinued at the end of the study. <h3>Conclusions.</h3> —An aggressive smoking intervention program significantly reduces the age-related decline in FEV<sub>1</sub>in middle-aged smokers with mild airways obstruction. Use of an inhaled anticholinergic bronchodilator results in a relatively small improvement in FEV<sub>1</sub>that appears to be reversed after the drug is discontinued. Use of the bronchodilator did not influence the long-term decline of FEV<sub>1</sub>. (<i>JAMA</i>. 1994;272:1497-1505)
Global health 2035: a world converging within a generation
Authors: Dean T Jamison, Lawrence H Summers, George Alleyne, Kenneth J Arrow, Seth Berkley, Agnes Binagwaho, Flavia Bustreo, David Evans, Richard G A Feachem, Julio Frenk, Gargee Ghosh, Sue J Goldie, Yan Guo, Sanjeev Gupta, Richard Horton, Margaret E Kruk, Adel Mahmoud, Linah K Mohohlo, Mthuli Ncube, Ariel Pablos-Mendez, K Srinath Reddy, Helen Saxenian, Agnes Soucat, Karen H Ulltveit-Moe, Gavin Yamey
Journal: The Lancet (2013)
Parasite Burden and Severity of Malaria in Tanzanian Children
Authors: Bronner P. Gonçalves, Chiung-Yu Huang, Robert Morrison, Sarah Holte, Edward Kabyemela, D. Rebecca Prevots, Michal Fried, Patrick E. Duffy
Journal: New England Journal of Medicine (2014)

Severe Plasmodium falciparum malaria is a major cause of death in children. The contribution of the parasite burden to the pathogenesis of severe malaria has been controversial.
Physical Fitness and All-Cause Mortality
Authors: Steven N. Blair
Journal: JAMA (1989)

We studied physical fitness and risk of all-cause and cause-specific mortality in 10 224 men and 3120 women who were given a preventive medical examination. Physical fitness was measured by a maximal treadmill exercise test. Average follow-up was slightly more than 8 years, for a total of 110 482 person-years of observation. There were 240 deaths in men and 43 deaths in women. Age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10 000 person-years in the least-fit men to 18.6 per 10 000 person-years in the most-fit men (slope, —4.5). Corresponding values for women were 39.5 per 10 000 person-years to 8.5 per 10 000 person-years (slope, —5.5). These trends remained after statistical adjustment for age, smoking habit, cholesterol level, systolic blood pressure, fasting blood glucose level, parental history of coronary heart disease, and follow-up interval. Lower mortality rates in higher fitness categories also were seen for cardiovascular disease and cancer of combined sites. Attributable risk estimates for all-cause mortality indicated that low physical fitness was an important risk factor in both men and women. Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer. (<i>JAMA</i>. 1989;262:2395-2401)
The Decline in Blood Lead Levels in the United States
Authors: James L. Pirkle
Journal: JAMA (1994)

<h3>Objective.</h3> —To describe trends in blood lead levels for the US population and selected population subgroups during the time period between 1976 and 1991. <h3>Design.</h3> —Two nationally representative cross-sectional surveys and one cross-sectional survey representing Mexican Americans in the southwestern United States. <h3>Setting/Participants.</h3> —Participants in two national surveys that included blood lead measurements: the second National Health and Nutrition Examination Survey, 1976 to 1980 (n=9832), and phase 1 of the third National Health and Nutrition Examination Survey, 1988 to 1991 (n=12119). Also, Mexican Americans participating in the Hispanic Health and Nutrition Examination Survey, 1982 to 1984 (n=5682). <h3>Results.</h3> —The mean blood lead level of persons aged 1 to 74 years dropped 78%, from 0.62 to 0.14 μmol/L (12.8 to 2.8 μg/dL). Mean blood lead levels of children aged 1 to 5 years declined 77% (0.66 to 0.15 μmol/L [13.7 to 3.2 μg/dL]) for non-Hispanic white children and 72% (0.97 to 0.27 μmol/L [20.2 to 5.6 μg/dL]) for non-Hispanic black children. The prevalence of blood lead levels 0.48 μmol/L (10 μg/dL) or greater for children aged 1 to 5 years declined from 85.0% to 5.5% for non-Hispanic white children and from 97.7% to 20.6% for non-Hispanic black children. Similar declines were found in population subgroups defined by age, sex, race/ethnicity, income level, and urban status. Mexican Americans also showed similar declines in blood lead levels of a slightly smaller magnitude over a shorter time. <h3>Conclusions.</h3> —The results demonstrate a substantial decline in blood lead levels of the entire US population and within selected subgroups of the population. The major cause of the observed decline in blood lead levels is most likely the removal of 99.8% of lead from gasoline and the removal of lead from soldered cans. Although these data indicate major progress in reducing lead exposure, they also show that the same sociodemographic factors continue to be associated with higher blood lead levels, including younger age, male sex, non-Hispanic black race/ ethnicity, and low income level. Future efforts to remove other lead sources (eg, paint, dust, and soil) are needed but will be more difficult than removing lead from gasoline and soldered cans. (<i>JAMA</i>. 1994;272:284-291)
Wide QRS Tachycardia in the Conscious Adult
Authors: Russell T. Steinman
Journal: JAMA (1989)

Hemodynamic stability during wide QRS tachycardia is commonly, albeit erroneously, taken as evidence for a supraventricular mechanism. To determine the magnitude for potential misdiagnosis in applying this notion clinically, we analyzed 20 consecutive cases of regular wide QRS tachycardia in conscious adult patients (mean age, 64 years). The most common heart disease was atherosclerotic (75%), with an associated history of remote myocardial infarction in 73% of the cases. Tachycardia was sustained for a mean of 4.8 hours prior to medical evaluation, with a mean rate of 186 beats per minute and mean systolic blood pressure of 111 mm Hg. A diagnosis of ventricular tachycardia (VT) was established in 17 cases (85%). In the patients with VT, atrioventricular dissociation was recognized on the 12-lead electrocardiogram in 38%, with Wellens' morphological features favoring the diagnosis in 73%. Following conversion to sinus rhythm, electrophysiological testing in 17 patients reproduced the clinical arrhythmia in 94% (with a replication rate of 100% in 15 patients with VT), with at least one additional unsuspected VT morphology induced in 53% of patients with VT. Thus, VT should be considered the most likely cause of regular wide QRS tachycardia in the conscious adult patient, especially with a history of remote myocardial infarction. Recognition of this simple principle and careful examination of the 12-lead electrocardiogram may help to prevent the misapplication of pharmacotherapy in the vast majority of these patients. (<i>JAMA</i>1989;261:1013-1016)
Improvement of Glycemic Control, Triglycerides, and HDL Cholesterol Levels With Muraglitazar, a Dual (α/γ) Peroxisome Proliferator–Activated Receptor Activator, in Patients With Type 2 Diabetes Inadequately Controlled With Metformin Monotherapy
Authors: David M. Kendall, Cindy J. Rubin, Pharis Mohideen, Jean-Marie Ledeine, Rene Belder, Jorge Gross, Paul Norwood, Michael O’Mahony, Kenneth Sall, Greg Sloan, Anthony Roberts, Fred T. Fiedorek, Ralph A. DeFronzo
Journal: Diabetes Care (2006)

OBJECTIVE—We sought to evaluate the effects of muraglitazar, a dual (α/γ) peroxisome proliferator–activated receptor (PPAR) activator within the new glitazar class, on hyperglycemia and lipid abnormalities. RESEARCH DESIGN AND METHODS—A double-blind, randomized, controlled trial was performed in 1,159 patients with type 2 diabetes inadequately controlled with metformin. Patients received once-daily doses of either 5 mg muraglitazar or 30 mg pioglitazone for a total of 24 weeks in addition to open-label metformin. Patients were continued in a double-blind fashion for an additional 26 weeks. RESULTS—Analyses were conducted at week 24 for HbA1c (A1C) and at week 12 for lipid parameters. Mean A1C at baseline was 8.12 and 8.13% in muraglitazar and pioglitazone groups, respectively. At week 24, muraglitazar reduced mean A1C to 6.98% (−1.14% from baseline), and pioglitazone reduced mean A1C to 7.28% (−0.85% from baseline; P &amp;lt; 0.0001, muraglitazar vs. pioglitazone). At week 12, muraglitazar and pioglitazone reduced mean plasma triglyceride (−28 vs. −14%), apolipoprotein B (−12 vs. −6%), and non-HDL cholesterol (−6 vs. −1%) and increased HDL cholesterol (19 vs. 14%), respectively (P &amp;lt; 0.0001 vs. pioglitazone for all comparisons). At week 24, weight gain (1.4 and 0.6 kg, respectively) and edema (9.2 and 7.2%, respectively) were observed in the muraglitazar and pioglitazone groups; at week 50, weight gain and edema were 2.5 and 1.5 kg, respectively, and 11.8 and 8.9%, respectively. At week 50, heart failure was reported in seven patients (five with muraglitazar and two with pioglitazone), and seven deaths occurred: three from sudden death, two from cerebrovascular accident, and one from pancreatic cancer in the muraglitazar group and one from perforated duodenal ulcer in the pioglitazone group. CONCLUSIONS—We found that 5 mg muraglitazar resulted in greater improvements in A1C and lipid parameters than a submaximal dose of 30 mg pioglitazone when added to metformin. Weight gain and edema were more common when muraglitazar was compared with a submaximal dose of pioglitazone.
If Nothing Goes Wrong, Is Everything All Right?
Authors: James A. Hanley
Journal: JAMA (1983)

PHYSICIANS frequently must provide patients with estimates of the risk of a particular medical procedure or of the probability of a specific health outcome. To do so, they may use data from their own experiences as well as those available in the literature. A general goal is to locate the estimate within a fairly narrow range. When the procedure or outcome of concern is relatively uncommon, precise estimation, although desirable, may be difficult or impossible. Moreover, when the only data available come from a study in which none of the events of concern actually occurred—ie, a study in which a zero numerator is reported—making inferences seems to be particularly problematic. Because the occurrence of "no events" seems to be viewed as very different both quantitatively and qualitatively from the occurrence of one or more events, it is useful to look into someof the statistical and psychological issues that influence the
Clinical Anatomy of the Liver: Review of the 19th Meeting of the Japanese Research Society of Clinical Anatomy
Authors: Yoshihiro Sakamoto, Norihiro Kokudo, Yoshikuni Kawaguchi, Keiichi Akita
Journal: Liver Cancer (2016)

Precise clinical knowledge of liver anatomy is required to safely perform a hepatectomy, for both open and laparoscopic surgery. At the 19th meeting of the Japanese Research Society of Clinical Anatomy (JRSCA), we conducted special symposia on essential issues of liver surgery, such as the history of hepatic segmentation, the glissonean pedicle approach, application of 3-D imaging simulation and fluorescent imaging using indocyanine green solution, a variety of segmentectomies including caudate lobectomy, the associating liver partition and portal vein embolization for stage hepatectomy and harvesting liver grafts for living donor liver transplantation. The present review article provides useful information for liver surgeons and anatomic researchers.
Perioperative Results and Complications in 15,964 Transcatheter Aortic Valve Replacements
Authors: Thomas Walther, Christian W. Hamm, Gerhard Schuler, Alexander Berkowitsch, Joachim Kötting, Norman Mangner, Harald Mudra, Andreas Beckmann, Jochen Cremer, Armin Welz, Rüdiger Lange, Karl-Heinz Kuck, Friedrich W. Mohr, Helge Möllmann
Journal: Journal of the American College of Cardiology (2015)
In vivo bioprinting: Broadening the therapeutic horizon for tissue injuries
Authors: Wenxiang Zhao, Chuxiong Hu, Tao Xu
Journal: Bioactive Materials (2023)

Tissue injury is a collective term for various disorders associated with organs and tissues induced by extrinsic or intrinsic factors, which significantly concerns human health. In vivo bioprinting, an emerging tissue engineering approach, allows for the direct deposition of bioink into the defect sites inside the patient's body, effectively addressing the challenges associated with the fabrication and implantation of irregularly shaped scaffolds and enabling the rapid on-site management of tissue injuries. This strategy complements operative therapy as well as pharmacotherapy, and broadens the therapeutic horizon for tissue injuries. The implementation of in vivo bioprinting requires targeted investigations in printing modalities, bioinks, and devices to accommodate the unique intracorporal microenvironment, as well as effective integrations with intraoperative procedures to facilitate its clinical application. In this review, we summarize the developments of in vivo bioprinting from three perspectives: modalities and bioinks, devices, and clinical integrations, and further discuss the current challenges and potential improvements in the future.
Overall survival in advanced epidermal growth factor receptor mutated non-small cell lung cancer using different tyrosine kinase inhibitors in The Netherlands: a retrospective, nationwide registry study
Authors: Rolof G.P. Gijtenbeek, Ronald A.M. Damhuis, Anthonie J. van der Wekken, Lizza E.L. Hendriks, Harry J.M. Groen, Wouter H. van Geffen
Journal: The Lancet Regional Health - Europe (2023)

Clinical guidelines advise osimertinib as preferred first line treatment for advanced epidermal growth factor receptor (EGFR) mutated non-small cell lung cancer (NSCLC) with deletions in exon 19 (del19) or exon 21 L858R mutation. However, for first-line osimertinib the real world overall survival (OS) in mutation subgroups remains unknown. Therefore, the aim of this study was to evaluate the real-world OS of those patients treated with different generations of EGFR-tyrosine kinase inhibitors (TKI), and to identify predictors of survival.Using real-world data from the Netherlands Cancer Registry (NCR) we assessed patients diagnosed with stage IV NSCLC with del19 or L858R mutation between January 1, 2015, and December 31, 2020, primarily treated with then regularly available TKIs (including osimertinib).Between January 1, 2015, and December 31, 2020, 57,592 patients were included in the NCR. Within this cohort we identified 1109 patients, 654 (59%) with del19 and 455 (41%) with L858R mutations, respectively; 230 (21%) patients were diagnosed with baseline brain metastases (BM). Patients were treated with gefitinib (19%, 213/1109), erlotinib (42%, 470/1109), afatinib (15%, 161/1109) or osimertinib (24%, 265/1109). Median OS was superior for del19 versus L858R (28.4 months (95% CI 25.6-30.6) versus 17.7 months (95% CI 16.1-19.5), p < 0.001. In multivariable analysis, no difference in survival was observed between various TKIs in both groups. Only in the subgroup of patients with del19 and baseline BM, a benefit was observed for treatment with osimertinib.In this nationwide real-world cohort, survival of Dutch patients with advanced NSCLC and an EGFR del19 mutation was superior versus those harboring an L858R mutation. Osimertinib performed only better as first-line treatment in patients with del19 and BM.None.
From the Authors
Authors: B. Klug, K.G. Nielsen, H. Bisgaard
Journal: European Respiratory Journal (2001)

KLUG et al. [1] have reported observer variability within and between two experienced observers of a number of lung function measurements in preschool children.One of the methods assessed was the measurement of airway resistance by the interrupter technique (Rint).In their laboratory, Rint measurements have high interobserver variability, although no systematic bias.In our laboratory interobserver variability of Rint measurements is measured with each new observer to ensure that it is acceptable [2].Although our withinobserver variability is similar to that reported by KLUG et al., the between observer variability is much lower, despite differences in experience.There is no systematic bias.KLUG et al. have shown a variance (2 SDs of the differences between observers measurements) of 0.62 kPa .L -1 .s, where ours is 0.14-0.18kPa .L -1 .s (table 1).Our 95% limits of agreement are therefore much narrower.It is misleading to imply that interobserver repeatability for Rint is generally poor.Technical aspects of measurement and different criteria for accepting measurements both affect repeatability.Each laboratory should have its own standards for intra-and interobserver repeatability and use these to power proposed studies.